BOARD QUESTIONS.....

The BOARD QUESTIONS herein, are examples of real cases enountered in clinical practice.
All of the questions are materially simulated by the author.



Q   1.   Patient is a 21 y/o white male  presents to the ED with 10 days
            hx. of malaise,low grade fever and sore throat. Appetite is poor.
            Also noted that minimal amount of eating gives him a sense
            of fullness with a mild LUQ discomfort. C/o aching in left shoulder.
            He is a college student. No recent travels or pet ownership noted.
            Past medical/surgical histories are negative.
.
            On exam, appears prostrated, but non toxic.  Vitals normal, except for
            oral temp. of 100.7 F.   ENT exam shows redness & exudate of the pharynx.
            Mild submandibular adenopathy and LUQ fullness is noted on palpation.

            Based on the  history alone, what is the LIKELY diagnosis?

           A.  Acute Viral Pharyngitis
           B.  Acute Exudative Tonsillitis
           C.  Vincent's Angina
           D.  Acute Herpangina
           E.  Acute Infectious Mononucleosis


Q   2.  Patient is a 33 y/o white female presented to her PCP with 3 -4 day history
           of high fevers, cough, malaise and  myalgias. Has been taking OTC
           antipyretics and antitussives. Today noted pleuritic pain  with deep
           breaths.  Pt. is a librarian by profession. Owns a recently purchased
           parakeet. Pt. was well prior to onset of illness. Lives alone.
           No recent travels. Past medical/surgical histories are negative

           On exam  appears ill, with paroxysms of deep cough. Oral temp. 103.2 F.
           EENT=unremarkable.  LUNGS=Scattred ronchi bilaterally.
           Rest  of the physical exam is normal. No rash of synovitis are noted.

           Based on the above H&P, what is the likely diagnosis?

           A.  Acute Chlamydia Pneumonia
           B.  Acute Mycoplasma Pneumonia
           C.  Acute Legionnaire's Pneumonia
           D.  Acute Psittacosis
           E.  Lofgren's Syndrome
           


 Feel free to select the ONE correct choice.  The next POSTING will have the answers.